Clinical

HCV superinfection hazardous in hepatitis B patients

Last Updated: 2004-04-14 10:36:47 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Acute hepatitis C virus (HCV) superinfection may have serious consequences in patients with chronic hepatitis B virus (HBV) infection, Taiwanese researchers report in the April issue of Gastroenterology. The outcome is ultimately worse than that following hepatitis delta virus (HDV) superinfection.

In fact, as lead investigator Dr. Yun-Fan Liaw told Reuters Health, "in view of the grave prognosis, especially of HCV superinfection, it is very important to prevent the transmission of these viruses to patients with underlying liver disease."

Dr. Liaw, and colleagues at Chang Gung University in Taipei, came to this conclusion following a study of various groups of HBV patients. These included 93 HBV patients with HCV superinfection and 190 HBV patients with HDV superinfection.

The acute HCV superinfection typically occurred as acute icteric hepatitis. Hepatic decompensation developed in 34% of these patients, hepatic failure was seen in 11% and 10% died. The corresponding proportions in HDV superinfection were 31%, 9% and 7%.

However, follow-up showed that in the HCV group, the 48% cumulative incidence of cirrhosis at 10 years was significantly higher than that in the HDV superinfection group or in those with chronic HBV infection alone. This was also true of hepatocellular carcinoma in the HCV group--the incidence at 10 years was 14% and reached 32% at 20 years.

Thus, the researchers conclude that the long-term prognosis of HCV superinfection in such patients is "much worse than that following acute HDV superinfection or active chronic hepatitis B."

Gastroenterology 2004;126:1024-1029.